YEAR 05 • ADVANCED CLINICAL

Anaesthesia & Critical Care

20 learning units • 100 chapter sections • 200 explained questions. Prepare patients for anaesthesia, recognise perioperative emergencies and understand organ support, critical-care teamwork and recovery.

Original RAHBAR study material for the Year 5 learning pathway. Clinical cases support supervised undergraduate learning. Treatment choices, doses and procedures must follow current local protocols and the responsible clinical team. References & further reading ↓

MODULE 16 / 20

Perioperative Emergencies

Recognise anaphylaxis and malignant hyperthermia and summon protocol-led specialist treatment.

Quick revision ↓ Medical Dictionary

01Recognise anaphylaxis

Sudden hypotension, bronchospasm or airway swelling after an exposure should raise concern for anaphylaxis. Skin signs can be absent or concealed during surgery. Stop the suspected trigger where possible, call for help and support airway, breathing and circulation immediately.

02Treat and document

Adrenaline is the key treatment for anaphylaxis; route and dosing depend on setting and expertise, with intravenous use reserved for appropriately experienced clinicians. Follow the local emergency algorithm. Record timing, exposures and treatment, obtain recommended samples and arrange specialist allergy review.

03Recognise malignant hyperthermia

An unexplained rise in carbon dioxide production, tachycardia, rigidity and metabolic disturbance during trigger exposure can indicate malignant hyperthermia. Marked temperature elevation may be a later sign. Relevant family or personal history should prompt specialist planning before anaesthesia.

04Respond to the crisis

Stop triggering agents, call the malignant-hyperthermia response team and follow the current crisis checklist. Trained teams provide oxygenation and ventilation, dantrolene and treatment of associated physiological disturbances. Continuing monitoring is necessary because complications or recurrence can follow initial improvement.

05Learn from emergencies

Use readily accessible cognitive aids, closed-loop communication and clearly assigned roles. After stabilisation, explain the event and future precautions, document accurately and arrange appropriate referral. A suspected reaction must not be reduced to an unexplained allergy label without follow-up.

High-Yield Revision

Anaphylaxis may occur without visible skin signs.
Do not wait for extreme fever to suspect malignant hyperthermia.
Document exposures and arrange follow-up.

Common Pitfalls

Treating antihistamines as a substitute for emergency anaphylaxis treatment.
Restarting a suspected trigger after temporary improvement.

References & Further Reading

Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.

Reference review: 29 September 2026. Consult current local protocols for prescribing, procedures and escalation.